Thursday, November 19, 2009

Healthcare Reform: Treating the Symptoms and not the Cause

President Obama, Hillary Clinton, and the majority leaders in both houses of Congress are not the first group of people to realize that the health care system in the United States is in need of reform. The US Conference of Catholic Bishops has been preaching on this for decades. The fact that health care costs have risen so high to the point where tens of millions of Americans cannot afford health care coverage or elect not to pay for it suggests that the current system is broken. Access to affordable health care is a key component of Catholic Social Teaching and the fact that millions of Americans do not have access to it is simply wrong; dare I say sinful. The Bishops are right to call for reform.

This issue has become politicized, meaning that a lot of people on both sides of the aisle use manipulated data points and fear tactics to push their agendas. Really difficult problems become very simple (albeit watered down) sound bytes. The average American has no idea what the proposed House bill is all about; it is, of course 2,000 pages long and no doubt filled with all of that legal mumbo jumbo that causes me to break out in hives (personally, the world would be better off with fewer lawyers and fewer tax accountants, but that is another post all together). The point is, all most of us know about this legislation is what we hear politicized on the news.

One issue that has received a lot of airtime surrounds whether or not federal dollars will be used to fund abortions. With over 50% of people in this country now considering themselves pro-life, the thought that their tax dollars may be used to fund abortions is, frankly, sinful. Initially, the President understood and respected this position as he, on multiple occasions, pointed out that abortion will not be covered by the legislation under consideration. However, over the past few decades we have come not to take our politicians at their word so, when a House Democrat from Michigan, Bart Stupak, pushed for an amendment clearly spelling out that federal dollars would not be used to fund abortions, President Obama should have been relieved for 2 reasons; 1 it clearly states something the president has promised and 2. this amendment was the primary reason the house voted in favor of the bill.

The fallout from this event has been interesting to watch. The President and speaker Pelosi along with other pro-abortion democrats are not happy with the House bill in its current form. They are not pleased with the Stupak amendment and many in the senate have pledged not to vote for any health care reform bill that contains this language. Given the President’s multiple statements regarding abortion and healthcare reform, it begs the question, why?

Put that maddening puzzle aside for a second. I suggest that even if you are pro-abortion, you should be in favor of the Stupak amendment if you want this bill to pass. Here’s why:

  1. The bill does not prevent abortion from being funded by federal dollars in the case of rape, incest, or when the mother’s life is in danger. Otherwise, arguably abortion is not a necessary medical procedure but rather an elective surgery. Which other elective surgeries are covered by this proposed legislation?
  1. Abortions are actually one of the least expensive medical procedures to have performed, particularly early on in a pregnancy. In fact, it costs less for an early term abortion than it does for many vision procedures or dental procedures that are not covered by most health plans.
  1. This amendment does not ban abortion, it simply prohibits the use of federal dollars to fund abortions under the new legislation. It simply applies the principles of the Hyde Amendment to this new legislation. As such, cost to the woman seeking an abortion do not change as a result of the Stupak Amendment nor does her access to having that abortion.

All of this, however, should be a moot point. With or without abortion, health care reform, as it is being addressed by the administration and congress, should not see the light of day because it does not address the root causes of why health care costs have escalated to where they are. Consider the following:

  1. Doctors have to charge higher fees to cover exorbitant malpractice insurance premiums. Additionally, healthcare costs rise when doctors order unnecessary tests to cover their “you know whats” for fear of misdiagnosis which can lead to further legal liability. If this liability is not “capped,” this cycle of high premium/unnecessary tests will expand and continue to add to inflation in the healthcare sector.
  1. Managed care organizations (of which the government is proposing to become the largest if the public option passes) only reimburse doctors a fraction of their fees. Additionally, doctors have to wait a long time to get paid and, as a result, must see more patients to maintain their income (and pay off all those debts incurred in medical school). Seeing 30+ patients a day (and finding the time to deal with multiple insurance hassles – ie taking multiple calls from a pharmacy about Ms. Smith's Medicare not covering Forteo) leads to fatigue, which increases the possibility of making a misdiagnosis.

The interrelated dynamics of number 1 and number 2 are what cause healthcare costs to continually inflate. They will continue to do so even if every American has affordable healthcare available to them. As a result, our taxes will increase proportionately. We will not be solving the healthcare cost crises; rather, we will be funding costs that will continue to escalate by robbing from Peter to pay Paul. Responsibility will now be on a wider base of Americans (i.e. all tax payers) vs. just those who currently pay for premiums. The fact that not all Americans pay taxes, but will have access to government sponsored healthcare is another post all together.

Real healthcare reform must address the root causes of escalating healthcare costs. Otherwise you are treating the symptom and not the cause. As such, with or without the Stupak amendment, this administration’s approach to healthcare reform should takeoff like a led zeppelin.


  1. A healthcare system which ranks most responsive in the world, in which life saving medicines and procedures are given to those who are in the throws of the gravest illnesses, where the technologies are cutting edge and where NO ONE goes without care is not a systeem in need of reform.

    Individual items which affect the system negatively (like the legal system and the patent system)can be reformed and have very positive impacts on the affordability of healthcare. And you don't have to tthrow the baby out with the bath water to get there.

    Tort reform alone would be a huge improvement.

    You also neglect to point out the dangers of a federal live in stamford, you have city trash collection...once a week and you have to bring your can to the curb and take it back...when I was a kid, it was twice a week, they came up the drive way and got your garbage and brought your cans back up...but budget constraints forced cutbacks when it comes to services rendered...something to think about. But if you listen to the president he will tell you, well you can go purchase your own healthcare...really? Mike, how many private residential trash collection companies operate in Stamford? How many insurance companies will still be in the business of health insurance.

    Some will ask, do you really distrust the gov't this much? isn't distrust of the gov''s distrust of lack of choice. I'll take my chances with 1300 health insurance companies versus a single payer.

    And let's not forget how well the gov't has done with funding entitlements like social security and medicare.

    And let's look at England...their heaalthcare systeem is broken...people are denied treatments, people wait for access and it is WAY underfunded.

    This bill is a's wrong for the country.

  2. Just to point something out...I do live in stamford, I pay 5 figures in taxes and I don't have city pickup, city water, or city sewers....

  3. I forgot to mention that I pay for my kids to go to school....

  4. You don't have city trash collection?!?!?! WTF is that?!?!?! I knew you didn't have water or sewer (actually Don and Arlene Carlon tap water was the first well water I ever drank).

    So 80 yearold sick person = North Stamford resident.

    You've lived 80've had enough. You live in North Stamford you have enough to pay for your own trash.

  5. Wow. Right wing tool much? Everything you wrote here is not only demonstrably wrong, it's full of straw men. You have obviously read only talking points, not the legislation involved. You should be embarrassed. Bearing false witness is a sin.

  6. "And let's look at England...their heaalthcare systeem is broken...people are denied treatments, people wait for access and it is WAY underfunded."

    That is an outright lie. Have you ever been here?

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  8. Dave

    I have never been accused of being right wing anything. Regarding England, it looks as if you are responding to a comment made by another reader. Take up your England argument with him. And yes, I have been to England on business many times. Contrary to popular opinion, I find the food to be good but the pubs close too early.

    Further, no I have not read the entire legislation, and cannot say I know anyone who has, including my representative Jim Himes who voted for the house bill. That he has not read what he has voted for seems to me as another way of bearing false witness.

    All I suggest in the content of my post is that any healthcare reform that does not tackle the root causes of inaffordability should not see the light of day. Yes, this means capping malpractice payouts. In your reading of the bill as presented by the US house of representatives, can you say whether or not the legislation caps malpractice? Giving health insurance access to everyone is one thing, but treating the root causes of why health insurance (and healthcare in general) continues to outpace the rate of inflation is another.